Syed Shafeeq Ur Rahman, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME86628 Issued in FL

Practice address

805 Virginia Ave
Suite 16
Fort Pierce, FL 34982-5881

Phone

(772) 468-6969

Fax

(772) 465-5160

NPI assigned

Dec 13, 2006

Last updated

Dec 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Syed Shafeeq Ur Rahman PA

  • Clinic/Center
  • Fort Pierce, FL
  • NPI 1821233305
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1518028679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 VIRGINIA AVE",
            "address_2": "SUITE 16",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349825881",
            "telephone_number": "772-468-6969",
            "fax_number": "772-465-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 VIRGINIA AVE",
            "address_2": "SUITE 16",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349825881",
            "telephone_number": "772-468-6969",
            "fax_number": "772-465-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "SYED SHAFEEQ",
        "middle_name": "UR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME86628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Maria Quintero, MSW
• R Edward Montejo MD PA
• Rad Onc Group LLC
• Pedram Rad, MD
• Raheel Ahmed MD PA
• Rai Care Centers of Florida I, LLC (Rai - Ohio Avenue - Fort Pierce)
• Mary Louise Rainer, LM
• Jennifer Renee Rainey, CRNA
• Gauresh Ramakrishna
• Moti N Ramgopal, MD

• General Practice Physician in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.